# JAMES H PETERSEN MD PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1780638411
- **Authorized official:** JAMES H PETERSEN MD PC (PRESIDENT OWNER)
- **Authorized official phone:** (503) 297-7223

## Contact information

- **Practice address:** 900 SUNSET DRIVE, GRANDE RHOODE HOSPITAL, LA GRANDE, OR 97850
- **Practice address phone:** (541) 963-1401
- **Practice address fax:** (541) 963-1502
- **Mailing address:** 5319 SW WESTGATE DR, \#241, PORTLAND, OR 97221-2432
- **Mailing address phone:** (503) 297-7223
- **Mailing address fax:** (503) 297-7603

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | MD08688 | OR | Yes |

## Other

- **Enumeration date:** 05/19/2006
- **Last updated:** 08/22/2020